Registration

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family Information

	First Name:*	Last Name: *
	Type*
	Home Phone:	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Emergency Contact Info (Not Contact #1 or #2)*

Students entered below will be added to your family's account

Add New Student #1:

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)
	Student Email:
	School:*	Grade Level:*
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):
	Medications (Leave blank if NONE):

Questions/Options:


How many years have you studied ballet? *
Are you on pointe? If yes, for how many years? *
What other styles of dance have you studied and for how many years? *
Have you performed in a Nutcracker before? If yes, what roles have you held? *
What is your home studio?*
Are you available to rehearse on Saturdays between the hours of 9am and 5pm?*
Are you available to rehearse on Sundays between the hours of 1pm and 7pm? *
Do you have any weekends where you will not be able to rehearse? We will not hold rehearsals on Thanksgiving weekend. *

Additional Information:

Mandatory Rehearsals and Fees

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I've read the above and agree.

Dropping

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INDEMNIFICATION AND RELEASE

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Enter your Full Name: